So it begins...I hope

[Just1Starfish 1]

Hello....first time poster here.

I've started the process to have a consultation with a surgeon for Gastric sleeve surgery. As of now, I'm about 5 lbs short of 40 BMI, and have absolutely no co-morbids. I've watched the educational video and have received their information packet in the mail. I have been eating and trying to gain weight (which sounds completely counter-intuitive) because I REALLY want to have surgery. I had started the process twice before...actually had the psych eval, and went through 6 months of medically supervised weight loss, and tried every diet known to man. I got discouraged with the medically supervised weight loss because I plateau'd for several weeks and then despite changes, I actually gained weight. None of that program was covered by my insurance, so when they said I needed to come in more often (3x/week instead of once every 2 weeks), I just stopped.

I had always thought I was 5'1" but at my most recent doctor's appointment they said 152CM, which comes out to 4' 11-3/4". Current weight is 201.5, which all calculates out to BMI 39.6. I've held off on taking the next steps in the packet because I'm not yet 40 BMI.

My insurance is BC/BS Federal employees...anyone have experience with them? What happens if I get approved and then lose weight on the 2 week diet? I'm going to barely qualify as it is.

Anxiety level is very high, but I want to do this. I'm sick of hating every picture I see of myself, and constantly being tired from lugging around 85 extra pounds. (sigh). I'm most concerned about not qualifying on insurance. Any encouragement would be very welcome.... Thanks!

[Jaelzion 970]

It's funny you mention your height changing. I was always told I was 5" and 1/2" tall. Then in the last few years, they started measuring me at 5'1". I know I haven't grown at my age, LOL. Maybe it's posture related, I don't know.

I don't know how the Federal plan is structured, but my BC/BS plan really did not look for ways to disqualify me. And the list of comorbidities is pretty broad:

• Osteoarthritis
• sleep Apnea
• High Blood Pressure
• High Cholesterol
• Type 2 Diabetes
• Venous Stasis Disease
• Soft Tissue Infections
• Back or Joint Pain

You have NO back pain or joint pain from being overweight? No osteoarthritis in knees or hips? Those are both super common. In any case, I hate that you have to deliberately gain weight, but if that's what it takes...

Best wishes, if BC/BS treats you like they treat me, you won't have any issues with preauthorization.

[newyorklady20 95]

Hi OP, I was in a very similar situation to you. I was a few pounds short of meeting the requirements and so I took a few months, I gained a few “naturally”, and then went back again and wow, I was a BMI of 40 lol. I have GHI NYC city employee insurance and for ours, it only counted of you met the BMI qualification for your first weigh in. The surgeons office should be able to tell you though. Just try to maintain it for a few months, and they’ll tell you if they want you to lose. For my last weigh in I was below 40 BMI. I was approved though and am starting the liquid diet tomorrow!
I would suggest writing down your questions and then calling your insurance and surgeons offices. They have heard a lot of it before! Good luck!

[lizonaplane 825]

I have heard that once you start the pre-op diet they don't count any weight loss against you. Did you talk to the program to see if their advice is to gain weight?

I am in the process of jumping through hoops too. My BMI was 49.6 but it's now down to 46. I don't think it will get too much lower. I've lost 18 lbs but I seem to have stalled.

I don't have any back pain and I didn't start having any joint pain until I started exercising in the last two months after being really sedentary for the entire pandemic.

Good luck!

[ReillysMami 0]

On 3/15/2021 at 4:06 PM, newyorklady20 said:

Hi OP, I was in a very similar situation to you. I was a few pounds short of meeting the requirements and so I took a few months, I gained a few “naturally”, and then went back again and wow, I was a BMI of 40 lol. I have GHI NYC city employee insurance and for ours, it only counted of you met the BMI qualification for your first weigh in. The surgeons office should be able to tell you though. Just try to maintain it for a few months, and they’ll tell you if they want you to lose. For my last weigh in I was below 40 BMI. I was approved though and am starting the liquid diet tomorrow!
I would suggest writing down your questions and then calling your insurance and surgeons offices. They have heard a lot of it before! Good luck!

I am a city employee as well? How long did it take you for them to give you a surgery date? i’m so interested. I’m above the bmi of 40. emblemhealth ghi is my insurance